Xu Wei-Hai, Li Ming-Li, Niu Jing-Wen, Feng Feng, Jin Zheng-Yu, Gao Shan
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
J Neurol Sci. 2014 Apr 15;339(1-2):130-3. doi: 10.1016/j.jns.2014.01.042. Epub 2014 Feb 6.
We aim to report the "deep tiny flow voids" (DTFV), a unique HR-MRI finding suggestive of deep collateral vessels along middle cerebral artery (MCA) occlusions.
We retrospectively reviewed the HR-MRI data of 60 patients with unilateral MCA occlusion (32 symptomatic and 28 asymptomatic) and 205 control subjects with normal MCA on magnetic resonance angiography. The presence or absence of DTFV, defined as three or more flow voids along the occluded MCA on at least two consecutive T2-weighted image slices, was observed. The relationships among DTFV, clinical presentations, and infarct sizes were analyzed.
DTFV were identified in 20/28 (71%) patients with asymptomatic MCA occlusions, much more frequently than in the patients with symptomatic occlusions (5/32, 16%) (P<0.001). There were 9 patients with a large territorial infarction (≥ 1/3 MCA distribution), none of whom had DTFV on HR-MRI. DTFV was not observed in any control subject.
DTFV are pathological conditions and associated with relatively good imaging outcomes and asymptomatic MCA occlusions. The function and clinical implications of DTFV warrant further investigations.
我们旨在报告“深部微小血流空洞”（DTFV），这是一种独特的高分辨率磁共振成像（HR-MRI）表现，提示大脑中动脉（MCA）闭塞时存在深部侧支血管。
我们回顾性分析了60例单侧MCA闭塞患者（32例有症状，28例无症状）以及205例磁共振血管造影显示MCA正常的对照者的HR-MRI数据。观察是否存在DTFV，其定义为在至少两个连续的T2加权图像切片上沿闭塞的MCA出现三个或更多血流空洞。分析DTFV、临床表现和梗死大小之间的关系。
28例无症状MCA闭塞患者中有20例（71%）发现DTFV，其出现频率远高于有症状闭塞患者（5/32，16%）（P<0.001）。有9例患者出现大面积梗死（≥1/3 MCA分布区域），这些患者在HR-MRI上均未发现DTFV。在任何对照者中均未观察到DTFV。
DTFV是一种病理状态，与相对较好的影像学结果及无症状MCA闭塞相关。DTFV的功能和临床意义值得进一步研究。
